{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:44:41Z","timestamp":1793882681446,"version":"4.7.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":24,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nutritional or systemic inflammatory markers like modified Glasgow Prognostic Score (mGPS), prognostic nutritional index (PNI), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are useful prognostic indicators, but their role in patients with unresectable or metastatic biliary tract cancer receiving gemcitabine plus cisplatin (GC) or GC plus durvalumab is unclear. This study investigates the relationship of these markers with treatment outcomes and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Chemotherapy consisted of protracted infusion of gemcitabine (1000\u2009mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day) and cisplatin (25\u2009mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day) on day 1 and 8, or gemcitabine (1000\u2009mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day), cisplatin (25\u2009mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day) on day 1 and 8 and durvalumab (1500\u2009mg\/day 1) given once every 21\u2009days. After six cycles of GC plus durvalumab therapy, durvalumab monotherapy was administered at 1500\u2009mg every 4\u2009weeks. PNI, NLR, PLR and mGPS were assessed before treatment using established cutoffs. Overall survival (OS) and time to treatment failure (TTF) were analyzed with Kaplan\u2013Meier and Cox regression models. The primary endpoint was OS, defined as the time from the start of chemotherapy to death.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This study analyzed 103 patients with unresectable or metastatic biliary tract cancer treated with GC or GC plus durvalumab. For patients with PLR \u2265 148 the median survival was 13.7\u2009months and for those with PLR\u2009&lt;\u2009148 the median OS was not estimated; this difference was significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016). For patients with mGPS 0\u20131 and 2 the median OS was 16.9\u2009months and 7.9\u2009months, respectively, and this difference was also significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Univariate analysis revealed that, among the nutritional or systemic inflammatory markers tested, mGPS 2 and PLR \u2265 148 significantly predicted shorter OS. Multivariate analysis further confirmed that mGPS 2 is an independent risk factor for shorter OS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A mGPS of 2 was a predictor of shorter OS for patients with unresectable or metastatic biliary tract cancer receiving GC or GC plus durvalumab. Evaluating mGPS prior to treatment initiation may support planning of individualized treatments that can enable clinicians to identify patients who are likely to benefit from chemotherapy and to exercise caution when considering systemic therapy for those with mGPS 2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40780-026-00555-5","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T12:35:50Z","timestamp":1771245350000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Relationship of nutritional or systemic inflammatory markers with efficacy of gemcitabine and cisplatin with or without durvalumab therapy for patients with unresectable or metastatic biliary tract cancer: a retrospective study"],"prefix":"10.1186","volume":"12","author":[{"given":"Yayoi","family":"Fukushi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuma","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumiko","family":"Akamine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Igarashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuya","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Kikuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"555_CR1","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/S0140-6736(21)00153-7","volume":"397","author":"JW Valle","year":"2021","unstructured":"Valle JW, Kelley RK, Nervi B, et al. 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